Ask The Vet – Spine Surgery Therapy

10:01 pm

Ask the Vet

by Dr. Cheryl Burke

Dear Doctor,

Our 6 year dachshund, Delilah had emergency surgery 2 weeks ago to decompress her spinal cord from a ruptured disc. She is home with us now but cannot use her legs. We have noted that in the past 3 days she will wag her tail when she sees us. What can we do to help her recover?

Worried in Perry Hall

Dear Worried,

I have some experience with rehabilitation of dogs recovering from neurologic injuries. At Paradise Canine Rehab Center, we often consult with clients such as yourself as their pets heal from spinal surgery.

There are many factors that influence whether a dog will walk again. Most importantly is the timing of surgery and the condition of the spinal cord at surgery. Specifically the presence or absence of “deep pain” is a major prognostic (predictive) factor. If Delilah had lost the ability to feel deep pain prior to surgery and was operated on within a 12 hour window of when that injury occurred, she has a reasonable chance to recover. If for whatever reason, her treatment was more than 24 hours after the loss of deep pain, her chances of recovery are lessened. The term “deep pain” refers to the mental awareness of pain when a toe is pinched. Simply withdrawing the limb is not enough, they need to turn their head or cry to signify that the brain was aware that that toe hurt. If Delilah turns her head when her toe is pinched, that means that the deepest part of her spinal cord is intact. It means the toe, sensory nerves, the spinal cord and the spinal tracts that go all the way to the brain are intact. That is always good news. Sometimes the deep pain sensation is actually lost after surgery. That can mean that an area of the spinal cord actually necrosis (died). That is a serious post-operative situation and is not always recoverable.

rehabilitation of dogs With the availability of MRI’s we have much more information about the condition of the spinal cord pre-operatively. Even so, the cord itself cannot be sampled or biopsied without causing permanent damage to the cord. When we evaluate a patient in our rehab center, we look at all aspects of their post-operative status. We check incisions, urine and fecal continence, any sign of voluntary (intentional) motor function, balance, coordination and of course, pain level. We will review some possible assistive devices that can begin to introduce a more normal body posture with all four feet under her. For short-legged dogs like dachshunds, we will use a rolled up towel to create a support she can stand over which helps her to work on her strength and body control. We teach clients how to reinforce outdoor eliminations and how to make use of reflexes to encourage defecation outside.

When we evaluate a pet’s ability to move, we look at their ability to support weight on their legs. We might support them with a harness and observe them for subtle walking efforts. Lastly, we will work with them on our underwater treadmill which allows us to assist them and observe them in a water supported (de-weighted) environment. Roughly, the water will support 1/2 of the dog’s weight which helps a weak animal to walk with less assistance. Our treadmill is actually in a pool so a rehab team member can specifically move the patient’s limbs if necessary.

At the rehab center, we focus on functional recovery. Because our patients cannot speak or tell us what they are feeling, we work toward specific functional goals such as, the ability to turn over, to rise to stand, to stand without assistance, to eliminate outside etc. We take into consideration, the pet’s home situation; whether there are stairs or special circumstances that we need to consider in their recovery. If Delilah has deep pain, she will have a good chance for recovery with intelligent, attentive rehabilitation.